U. S. GAO - Health Care Fraud and Abuse Control Program: Improvements Needed in Controls over Reporting Deposits and Expenditures. To help combat fraud and abuse in health care programs, including Medicare and Medicaid, Congress enacted the Health Care Fraud and Abuse Control (HCFAC) program as part of the Health Insurance Portability and Accountability Act of 1. Health Care Fraud And Abuse Control Program Report FormatHIPAA). HIPAA requires that the Departments of Health and Human Services (HHS) and Justice (DOJ) issue a joint annual report to Congress on amounts deposited to and appropriated from the Federal Hospital Insurance (HI) Trust Fund for the HCFAC program. In April 2. 00. 5, GAO reported on the results of its review of HCFAC program activities for fiscal years 2. HHS and DOJ. The objectives of this requested review were to assess the extent to which HHS and DOJ (1) took actions to address the recommendations made in the 2. Health Care Fraud and Abuse Control Program. To help combat fraud and abuse in health care. to revise and strengthen the Health Care Fraud and Abuse Control Program (HCFAC) Report Completion Guide by including. Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2012 February 2013. TABLE OF CONTENTS Page. Executive Summary 1. Introduction 3. Health Care Fraud and Abuse Control Program (HCFAC or the Program. X. Compendium. Priority recommendations summarized. FY 2016 Work Plan. OIG projects planned for 2016. Semiannual Report. Significant OIG activities in 6-month increments. Compliance 101. Free educational resources. Advisory. . of 1986 specifically targeted healthcare fraud and abuse. Health Care Fraud and Abuse Control Program Annual Report for FY 2007. Health Care Fraud and Abuse Control Program Annual Report for FY 2007. HCFAC deposits and expenditures for fiscal years 2. GAO reviewed HHS and DOJ documentation; selected nongeneralizable samples; and interviewed agency officials. Although HHS and DOJ have taken action to address our previous recommendations aimed at improving procedures for recording HCFAC expenditures and issuing the annual HCFAC report, GAO found that controls are not sufficient to ensure that the report is accurate and supported. HHS and DOJ took action to address three of the four recommendations in GAO's 2. HCFAC expenditure data, and expediting the review process for issuing the annual HCFAC report. Neither agency agreed with the remaining recommendation to notify Congress on delays in issuing the HCFAC report within 1 month after missing the mandated January 1 deadline and thus, did not take action. However, in June 2. HHS and DOJ implemented an expedited review process for completing the HCFAC report. The fiscal year 2. HCFAC report was issued on January 2. According to DOJ officials responsible for preparing the HCFAC report, they intend to use this new expedited review process to meet the mandated deadline when preparing future year reports. Regarding the design of controls, while HHS and DOJ had designed polices and procedures for documentation that generally required the retention of documentation for 6 years, these did not provide sufficient controls to ensure adequate support of HCFAC deposits and expenditures, in accordance with internal control standards. Components at both HHS and DOJ that manage HCFAC activities did not include in their respective policies and procedures controls that specified the person responsible for maintaining the records, the location of records, or a combination of both. Health Care Fraud and Abuse Control Program 2012 Annual Report. Look Inside. Individual Login. Login: Login to access your account. Email Address: * Password: * Forgot your password? Reset here. Corporate Login. For. . today released the Heath Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal. A national Health Care Fraud and Abuse Control Program. activities with respect to health care fraud and abuse.. , acting through the Inspector General, designed to coordinate Federal, state and local law enforcement activities with respect to health care fraud and abuse. In its thirteenth year of operation, the Program=s continued. Health care fraud includes health insurance. There are many ways to report cases of fraud. If a patient or health care provider believes they have witnessed. Health Care Fraud and Abuse Control Program Report. The Department of Health and Human Services and the Department of Justice Health Care Fraud and Abuse Control Program Annual Report for FY 2003. DECEMBER 2004. GAO found instances at HHS and DOJ where documentation could not be provided to support HCFAC expenditures, such as time and attendance reports. Also, both agencies did not have sufficient monitoring controls such as reconciliations, comparisons, and supervisory reviews, as outlined in internal control standards, to ensure accurate reporting of HCFAC deposits and expenditures. As a result, GAO found instances where data recorded in accounting and payroll systems were inconsistent with other sources such as the HI trust fund statements and agency workload tracking systems. GAO also identified presentation errors in the 2. HCFAC reports. For example, in reviewing the line item for restitution and compensatory damages, GAO found that $7. HCFAC report was not transferred to the HI trust fund as stated in the report. These amounts, primarily related to Medicare Part B and Medicaid, were transferred to the Federal Supplementary Medical Insurance Trust Fund and the Medicaid appropriation account as required. These inaccuracies overstated the amount of funds transferred to the HI trust fund. GAO makes 1. 1 recommendations to HHS and DOJ to revise or develop written procedures that include documentation and monitoring controls for HCFAC activities and reporting. DOJ agreed with all four of its recommendations. Of the seven recommendations to HHS, it generally agreed with five, disagreed with one, and did not address the remaining recommendation.
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